Swathy Moorthy1, S. Chandrasekar2, S. Ramakrishnan3, Jayabalaji4
BACKGROUND
Cardiovascular diseases form the major cause of death in patients with end-stage renal disease, among which heart failure predominates the list. Right ventricular dysfunction significantly contributes to the cause of morbidity and mortality in chronic kidney disease patients. We observed for the presence of right ventricular dysfunction in stages 3 and 4 of chronic kidney disease patients.
MATERIALS AND METHODS
We enrolled 100 patients with chronic kidney disease stages 3 and 4 with glomerular filtration rate of 15-60 mL/mins./1.73 sq. m. based on MDRD formula. Two dimensional and M-mode echocardiography was performed in these patients. TAPSE values were used to assess right ventricular dysfunction and Right Ventricular End-Diastolic Diameter (RVEDD) was used to identify the presence of RV dilatation.
CONCLUSION
Right ventricular dysfunction and pulmonary hypertension start early and progresses as the chronic kidney disease progresses. Hence, early detection of RV dysfunction by TAPSE and measurement of SPAP for pulmonary hypertension by echocardiogram, which is a noninvasive and cost-effective modality could help in prognostication and better management of these patients.
RESULTS
35% of the study group had TAPSE value less than 16 mm suggestive of right ventricular dysfunction. 24 patients had right ventricular end-diastolic diameter more than 26 mm denoting the presence of RV dilatation. TAPSE values had a positive correlation with GFR. Renal parameters like urea, creatinine, calcium, phosphorus were significantly higher among the patients with right ventricular dysfunction compared to patients with no evidence of right ventricular dysfunction.
